VA Connected Care Provider Toolkit

Thank you for using the VA Virtual Care Clinicians Guide and Prescription Pad, and our other tools in our VA Connected Care Provider Toolkit. The Clinicians Guide aims to support VA staff in identifying what virtual care tools and programs to recommend to patients, and the Prescription Pad provides a method to communicate with patients what virtual care tools and programs to use and how to access them. We would like your feedback so that we can improve these products to best meet the needs of VA staff and Veterans. Please complete the following 2-3 minute voluntary feedback questionnaire.

For any questions or requests for training on these tools email us at: CHImplementation@va.gov

For more information about the Office of Connected Care (OCC) at VA's Central Office, go to https://www.connectedcare.va.gov

Digital copies of the VA Virtual Care Clinicians Guide and Prescription Pad are available online at: https://connectedcare.va.gov/outreach-toolkit

POC: Christina Armstrong, Ph.D., OCC Connected Health Implementation Strategies, christina.armstrong@va.gov

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* 1. What VISN are you in?

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* 2. What facility are you at?

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* 3. How many times have you used the following

	0	1-10	11-20	21-30	31-40	41-50	50+	N/A
VA Virtual Care Clinicians Guide	VA Virtual Care Clinicians Guide 0	VA Virtual Care Clinicians Guide 1-10	VA Virtual Care Clinicians Guide 11-20	VA Virtual Care Clinicians Guide 21-30	VA Virtual Care Clinicians Guide 31-40	VA Virtual Care Clinicians Guide 41-50	VA Virtual Care Clinicians Guide 50+	VA Virtual Care Clinicians Guide N/A
VA Virtual Care Prescription Pad	VA Virtual Care Prescription Pad 0	VA Virtual Care Prescription Pad 1-10	VA Virtual Care Prescription Pad 11-20	VA Virtual Care Prescription Pad 21-30	VA Virtual Care Prescription Pad 31-40	VA Virtual Care Prescription Pad 41-50	VA Virtual Care Prescription Pad 50+	VA Virtual Care Prescription Pad N/A
VA Clinicians Guide Weight Management Interventions	VA Clinicians Guide Weight Management Interventions 0	VA Clinicians Guide Weight Management Interventions 1-10	VA Clinicians Guide Weight Management Interventions 11-20	VA Clinicians Guide Weight Management Interventions 21-30	VA Clinicians Guide Weight Management Interventions 31-40	VA Clinicians Guide Weight Management Interventions 41-50	VA Clinicians Guide Weight Management Interventions 50+	VA Clinicians Guide Weight Management Interventions N/A
Annie Clinicians Guide	Annie Clinicians Guide 0	Annie Clinicians Guide 1-10	Annie Clinicians Guide 11-20	Annie Clinicians Guide 21-30	Annie Clinicians Guide 31-40	Annie Clinicians Guide 41-50	Annie Clinicians Guide 50+	Annie Clinicians Guide N/A

Other (please specify)

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* 4. Of the following available in the VA Provider Virtual Care Toolkit, please indicate how useful each is in supporting the use of virtual care tools and programs with your patients?

	Very useful	Moderately useful	Useful	Not useful	N/A
VA Virtual Care Clinicians Guide	VA Virtual Care Clinicians Guide Very useful	VA Virtual Care Clinicians Guide Moderately useful	VA Virtual Care Clinicians Guide Useful	VA Virtual Care Clinicians Guide Not useful	VA Virtual Care Clinicians Guide N/A
VA Virtual Care Prescription Pad	VA Virtual Care Prescription Pad Very useful	VA Virtual Care Prescription Pad Moderately useful	VA Virtual Care Prescription Pad Useful	VA Virtual Care Prescription Pad Not useful	VA Virtual Care Prescription Pad N/A
VA Clinicians Guide: Virtual Weight Management Interventions	VA Clinicians Guide: Virtual Weight Management Interventions Very useful	VA Clinicians Guide: Virtual Weight Management Interventions Moderately useful	VA Clinicians Guide: Virtual Weight Management Interventions Useful	VA Clinicians Guide: Virtual Weight Management Interventions Not useful	VA Clinicians Guide: Virtual Weight Management Interventions N/A
VA Annie Clinicians Guide	VA Annie Clinicians Guide Very useful	VA Annie Clinicians Guide Moderately useful	VA Annie Clinicians Guide Useful	VA Annie Clinicians Guide Not useful	VA Annie Clinicians Guide N/A

Other (please specify)

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* 5. Rate how strongly you agree/disagree with the following statements regarding adoption of VA Virtual Care Clinicians Guide and Prescription Pad

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Overall, I am satisfied with these tools	Overall, I am satisfied with these tools Strongly agree	Overall, I am satisfied with these tools Agree	Overall, I am satisfied with these tools Neutral	Overall, I am satisfied with these tools Disagree	Overall, I am satisfied with these tools Strongly disagree
It was simple to use these tools	It was simple to use these tools Strongly agree	It was simple to use these tools Agree	It was simple to use these tools Neutral	It was simple to use these tools Disagree	It was simple to use these tools Strongly disagree
I am comfortable using these tools	I am comfortable using these tools Strongly agree	I am comfortable using these tools Agree	I am comfortable using these tools Neutral	I am comfortable using these tools Disagree	I am comfortable using these tools Strongly disagree
It was easy to learn to use these tools	It was easy to learn to use these tools Strongly agree	It was easy to learn to use these tools Agree	It was easy to learn to use these tools Neutral	It was easy to learn to use these tools Disagree	It was easy to learn to use these tools Strongly disagree
These tools can be integrated into clinical practice at my facility	These tools can be integrated into clinical practice at my facility Strongly agree	These tools can be integrated into clinical practice at my facility Agree	These tools can be integrated into clinical practice at my facility Neutral	These tools can be integrated into clinical practice at my facility Disagree	These tools can be integrated into clinical practice at my facility Strongly disagree
It was easy to find the information I needed with these tools	It was easy to find the information I needed with these tools Strongly agree	It was easy to find the information I needed with these tools Agree	It was easy to find the information I needed with these tools Neutral	It was easy to find the information I needed with these tools Disagree	It was easy to find the information I needed with these tools Strongly disagree
These tools provide effective tools in identifying virtual care tools for patients	These tools provide effective tools in identifying virtual care tools for patients Strongly agree	These tools provide effective tools in identifying virtual care tools for patients Agree	These tools provide effective tools in identifying virtual care tools for patients Neutral	These tools provide effective tools in identifying virtual care tools for patients Disagree	These tools provide effective tools in identifying virtual care tools for patients Strongly disagree
These tools are supported by leadership at my facility	These tools are supported by leadership at my facility Strongly agree	These tools are supported by leadership at my facility Agree	These tools are supported by leadership at my facility Neutral	These tools are supported by leadership at my facility Disagree	These tools are supported by leadership at my facility Strongly disagree
The organization of information on these tools was clear	The organization of information on these tools was clear Strongly agree	The organization of information on these tools was clear Agree	The organization of information on these tools was clear Neutral	The organization of information on these tools was clear Disagree	The organization of information on these tools was clear Strongly disagree
I would recommend the use of these tools to others	I would recommend the use of these tools to others Strongly agree	I would recommend the use of these tools to others Agree	I would recommend the use of these tools to others Neutral	I would recommend the use of these tools to others Disagree	I would recommend the use of these tools to others Strongly disagree

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* 6. Rate the following that may be barriers to you and other staff in the integration of the VA Virtual Care Clinicians Guide and Prescription Pad with patients

	Not a barrier	Small barrier	Medium barrier	Large barrier
Time constraints/too busy	Time constraints/too busy Not a barrier	Time constraints/too busy Small barrier	Time constraints/too busy Medium barrier	Time constraints/too busy Large barrier	Time constraints/too busy
Don’t know virtual care tools and programs well enough	Don’t know virtual care tools and programs well enough Not a barrier	Don’t know virtual care tools and programs well enough Small barrier	Don’t know virtual care tools and programs well enough Medium barrier	Don’t know virtual care tools and programs well enough Large barrier	Don’t know virtual care tools and programs well enough
Cost or resources associated with use (i.e. printing hard copies)	Cost or resources associated with use (i.e. printing hard copies) Not a barrier	Cost or resources associated with use (i.e. printing hard copies) Small barrier	Cost or resources associated with use (i.e. printing hard copies) Medium barrier	Cost or resources associated with use (i.e. printing hard copies) Large barrier	Cost or resources associated with use (i.e. printing hard copies)
Lack of compensation for use (i.e. workload credit or continuing education)	Lack of compensation for use (i.e. workload credit or continuing education) Not a barrier	Lack of compensation for use (i.e. workload credit or continuing education) Small barrier	Lack of compensation for use (i.e. workload credit or continuing education) Medium barrier	Lack of compensation for use (i.e. workload credit or continuing education) Large barrier	Lack of compensation for use (i.e. workload credit or continuing education)
Need more training	Need more training Not a barrier	Need more training Small barrier	Need more training Medium barrier	Need more training Large barrier	Need more training
Lack of leadership support	Lack of leadership support Not a barrier	Lack of leadership support Small barrier	Lack of leadership support Medium barrier	Lack of leadership support Large barrier	Lack of leadership support

Other (please specify)

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* 7. What did you like most about the VA Virtual Care Clinicians Guide and Prescription Pad and these other tools?

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* 8. What recommendations do you have to improve the VA Virtual Care Clinicians Guide and Prescription Pad and these other tools?

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* 9. What additional resources or support do you think VA staff and patients need to make it easier to use the VA Virtual Care Clinicians Guide and Prescription Pad?